What if psychologists ruled the world? In real life?

NHS Déjà vu

The good news is that plans have been put forward to ensure that all 1.3 million healthcare assistants will have to pass a basic skills test, a “certificate of fundamental care”, before they can care for patients.

A review by Times journalist Camilla Cavendish following the Mid Staffordshire hospital scandal found that healthcare assistants spend more hands-on time with patients than nurses.

Her plan says that healthcare assistants should be called nursing assistants and be trained alongside nurses with mechanisms for getting rid of poor performers. They would also have a career path to allow the best of them to qualify as nurses without having a degree.

The Health secretary has ruled out full regulation so they wouldn’t be able to be struck off and the Royal College of Nursing supports some of the proposals.

Back in the 1960s there were two groups of general nurses. Student nurses who trained for three years and qualified to became State Registered Nurses (SRNs)and Pupil nurses who trained for two years to became State Enrolled Nurses.

In my local hospital you could easily tell who was who by the colour of their uniforms. Student nurses wore green and when they became SRNs they had a mid-blue uniform with a fancy belt and buckle (Sisters and more senior nurses wore dark blue). Pupil nurses wore purple and when they became SENs they wore brown uniforms. There were also cadet nurses aged under 17 who weren’t allowed on the wards who wore a pink or lilac gingham pattern uniform. Different hospitals had different colour schemes although mid-blue for SRN and dark blues for senior nurses was common. Nurse tutors sometimes wore maroon. You get the picture.

Then in the early 1990s it was decided that SENs should follow a conversion course to become an SRN as all nurses – SENs and State Registered Nurses (SRNs) – were required to train and convert to the new grade of Registered General Nurse (RGN).

Up to this point student nurses often lived in a nurses’ home in the hospital grounds and when they completed their training in the hospital’s school of nursing (a mixture of practical experience and classroom study) got a job at that hospital. When project 2000 came along that all changed – many would say for the worse. Nurse training was moved to higher education so that the students could obtain a diploma leading to a degree. Student nurses were educated in blocks of several weeks then sent out to hospitals in the region (not their local hospital) so they often found themselves travelling a long way to work. Not surprisingly drop-out rates were as high as 30%.

And on top of that they were only allowed to observe not actually get their hands dirty during their first blocks of work experience. Ward sisters were not happy about that as it created staff shortages on the wards. Previously student nurses were a key part of the team and a third year student was given a lot of responsibility. But in the drive towards making nursing an all-degree profession recruiters were looking for academic potential more than caring and compassion.

This lack of caring in nursing finally came to a head after a number of scandals in care homes and hospitals and this year the Chief Nursing Officer (CNO) Jane Cummings published a three year vision and strategy called Compassion in Practicesetting out the values nurses should adhere to known as the 6 Cs viz Care, Compassion, Competence, Communication, Courage, and Commitment.